The most important thing to me is having a honest relationship where the client leads the way. I do need to develop a bond where communication can flourish so I can listen and the elder can express their wishes.
Home care and assistance costs less then assisted living / nursing home care. I find many elders want to stay in familiar surroundings and personal belongings. There are advantages to moving to assisted living for many, however for those who want to live out their days at home, I can help you do that. I do not however have back up, if I am sick or need personal time I do not have a substitute to send in my place. I try to make up time I miss and do not miss very much work.
I have worked for a service and there are many good reasons to hire a reputable one. The one i began working for and was trained by was Home Instead. They are great people and very responsive to client needs and offer a lot of security.
The biggest problem for going through one is the cost. They have to charge more to cover their overhead: pay employees, train employees, insurance etc... The best thing is the back up they offer, they will send in a substitute when your care giver is sick or needs personal time. Also they make it very easy to cancel care giver service for a specific time if you give 24 hr notice. This can help keep the costs down for the client.
A care giver can become a god send, and a good friend. It is important that care giver and client establish a fondness for one another. Choose one with care. All the care givers I know are trustworthy kind loving people. I am!